37 yr old stroke victim brain scan shows eye movement & response to pain. on ventilator; top of skull may be removed 2 less pressure. is this progress?

Good sign: Especially if the responses are reliable and reproducible. Maybe a neurologist can answer too. Removing part of cranium may help further.

Decompressive Crani: After large strokes , brain develops swelling usually between 3-5 days after stroke . This requires decompressive hemi crani , which removes bony skull from same side of stroke. This is beneficial to be for within 48 hrs of stroke . It's hard to say this is progress and improvement based on your provided history.

Complex: Pts at age 37 yrs tend to develop a large amount of brain swelling secondary to a stroke, so control of intracranial pressure can be lifesaving. But sounds like a very critical situation. If you wish, could schedule Concierge visit to discuss further details, but you may gain more by family conference with her doctors.